Provider Toolkit
Plan basics
- Medicare Plus Blue PPO Manual — Updated April 2019 (PDF)
- Medicare Advantage PPO provider agreement and contract amendments
- Medicare Advantage library
Billing and payment
- Eligibility and coverage
- Billing members
- Submitting claims
- Overpayment
- Reimbursement
- Claims questions and appeals
- If you don't participate with Medicare
- Covered Laboratory Services for MPSERS Members (PDF)
Care management
Coverage details
- Medicare Plus Blue PPO benefit summary
- Enhanced benefits
- DME/P&O, medical suppliers and pharmacists
- Medicare Advantage PPO lab network
- Specialty care for Medicare Plus Blue PPO
- Prescription drugs, drug plans and vaccines
- Medicare Advantage PPO medical drug policies and forms
- Medicare Diabetes Prevention Program
Evaluation and management
- Hospice care
- How to Complete the Member Evaluation and Treatment Opportunities Report (PDF)
- How to Complete the Member Evaluation and Treatment Opportunity Report Video
- Instructions for the Patient Diagnosis Evaluation and Treatment Opportunities Report (PDF)
- Patient Diagnosis Evaluation and Treatment Opportunities Report Sample (PDF)
General Medicare resources
- Acronym list
- CMS Quality Star Ratings program
- CMS Quality Star Ratings: Clinical Quality Corner tip sheets
- CMS resources
- Medicare guidelines
- Types of products
Was this content helpful?